Vascular Surgeon

What vascular surgeons make

There is no vascular surgeon line in the federal wage survey. It files them under Surgeons, All Other, where the bottom tenth sat near $78,000 and the middle and top were suppressed because the survey stops publishing above $239,200. The current median for that mixed group is $414,010, and that is what the middle figure here is: an estimate covering several surgical specialties. Doximity's 2024 physician compensation report puts the vascular surgery average at $556,070.

What the specialty surveys say

That report is built on more than 33,000 surveys of full-time American physicians. It runs higher than the federal figure because it captures partners, call pay and production bonuses rather than only salaried employees.

What you earn while you train

Residents are salaried hospital employees. Seven years of that is a long time to be paid a nurse's wage while carrying medical school debt, though the debt clock is not the real cost. The hours are.

What it costs to get there

Bachelor's degree, public university, in state

Roughly $10,000 to $12,000 a year in tuition and fees

MCAT (Medical College Admission Test) and applications

About $350 for the test, then $1,000 to $3,000 applying to schools

Medical school, public and in state

Roughly $30,000 to $45,000 a year. Private schools cost more

USMLE (United States Medical Licensing Examination) steps

About $675 each for the first two steps, more for the third

Roughly, all in

$150,000 to $235,000

Tuition, fees, exams and kit. Not rent, food or travel

There is no cheap door. The low end is two years at a community college then two at an in state public university for the bachelor's degree, the Medical College Admission Test at about $350 with $1,000 to $3,000 in applications, four years of public in state medical school at roughly $30,000 a year, and the United States Medical Licensing Examination steps at about $675 each for the first two. The high end is four full years of in state university at $12,000 a year and medical school at $45,000 a year, with private schools higher again. The long surgical residency and fellowship are paid jobs, so they add years rather than tuition. Most graduates owe well over $150,000.

File the FAFSA (Free Application for Federal Student Aid) every year. Most medical students finish owing well over $150,000 in federal loans. Work at a nonprofit or government hospital and Public Service Loan Forgiveness can cancel the balance after 10 years of qualifying payments, with residency years counting toward those 10.

Benefits

• Malpractice insurance paid for you

  Vascular coverage is expensive, and employers almost always carry it.

• Signing bonuses and loan repayment

  Hospitals outside large metro areas cannot recruit vascular surgeons and pay heavily to try.

• Public Service Loan Forgiveness

  Most teaching hospitals are nonprofit, so the years you already worked count.

• Total job security

  A ruptured aneurysm cannot wait for a transfer. Any hospital with a trauma program needs this specialty on call.

The path

Thirteen to fifteen years after high school, by one of two routes.

1. 1

   High school

   Grades 11 and 12

   Top grades in biology, chemistry, physics and math, aimed at a competitive pre-medical undergraduate place.

2. 2

   Bachelor's degree

   4 years

   Any major, plus the pre-medical science courses. High GPA, research, clinical hours, and the MCAT (Medical College Admission Test).

3. 3

   Medical school

   4 years

   Two years of science then two of clinical rotations. Get into an operating room early and find a vascular mentor.

4. 4

   Residency, one of two routes

   5 to 7 years

   Either an integrated vascular surgery residency of five years straight out of medical school, or five years of general surgery followed by a two year vascular fellowship.

5. 5

   Board certification

   1 to 3 years after training

   The American Board of Surgery runs a vascular surgery qualifying examination and then a certifying examination. You have no more than seven academic years after training to finish both.

High school courses that help

• Biology and chemistry

  Required everywhere for pre-medical study.

• Physics

  Blood flow, pressure and imaging are physics, and physics is on the MCAT (Medical College Admission Test).

• Calculus and statistics

  Reading clinical trials is a lifelong part of the job.

• English

  You will explain amputation risk to frightened people. Clear speech is a clinical skill.

Time and money, at a glance

Years after high school

13 to 15

Admission

Medical schools take roughly 5% to 15% of applicants, and integrated vascular spots are far scarcer

Total tuition

$160,000 to $220,000 at in-state public rates

Paid while training?

Only from residency onward

A state license and a board certification

You need a medical license from the state board where you work, which means finishing medical school and passing all three steps of the United States Medical Licensing Examination. Certification in vascular surgery is separate, from the American Board of Surgery, and takes two exams: a qualifying examination and then a certifying examination, for which you must already hold a full unrestricted state license. Hospitals will not grant operating privileges without both.

What shapes the career after training

• Endovascular skills

  Repairing vessels through a catheter in the groin instead of opening the chest or belly. Now most of the caseload.

• Aortic surgery

  Complex aneurysm repair, concentrated at a small number of centers.

• Limb salvage and wound care

  Saving the feet of people with diabetes. Enormous need, and deeply unglamorous work.

• Academic practice

  Teaching residents and running trials, for less money than private practice.

Nice-to-haves

• Research during medical school

  Integrated vascular residency applicants are usually published.

• Ultrasound skills

  Vascular surgeons read their own scans, and many run their own vascular lab.

• Stamina

  An aortic case can run eight hours, and the emergencies come at night.

• A rural or underserved commitment

  State and federal loan repayment programs pay real money for a few years of service.

A typical day

In by 6am for rounds, then the operating room or the catheter suite: a bypass to save a leg, a stent in an aorta, a dialysis access for a kidney patient. Clinic on the other days, mostly older patients with blocked arteries, diabetes and smoking histories. Emergencies interrupt everything, because a ruptured aneurysm is measured in minutes.

The honest trade-offs

Work life

Typical hours

55 to 70 a week, plus call

Remote work

Almost none

Physical demand

High, long hours standing in lead

Unionized

No, though resident unions are spreading

Similar paths

• Cardiac SurgeonOperate on hearts. The longest training on this site, and near the top of the pay scale.
• General SurgeonThirteen years of training to become the person who opens someone up and fixes the problem.
• CardiologistA heart doctor who diagnoses and treats heart disease, often without ever opening the chest.

The specialty reinvented itself in one generation

Most aneurysm repairs used to mean opening the abdomen. Today a large share are done through a small puncture in the groin, and surgeons trained before that shift had to learn it mid-career.

The federal survey will not print the number

Wage surveys stop publishing above $239,200 a year, so several surgical specialties show a blank where the median should be. That is why estimates for this job come from private physician surveys instead.

You can skip general surgery now

The integrated pathway, introduced in the 2000s, lets a medical student match straight into a five year vascular residency instead of doing five years of general surgery first.

The work follows diabetes

Rising rates of diabetes and peripheral artery disease mean more limb salvage work every year, while the number of vascular surgeons has grown slowly. Demand is not the problem in this career.